Expanding hormone-free options: Integrating CycleBeads® through a participatory approach

High rates of contraceptive discontinuation and unwanted pregnancies suggest that additional family planning options are needed. The availability and use of fertility awareness-based methods (FAM) are low, yet many women desire a non-hormonal, noninvasive method. To expand choice and meet the needs of these women and their partners, the Standard Days Method® (SDM) was integrated into the family planning services of five health centers in California and Massachusetts, beginning with a needs assessment and followed by evaluation research. SDM, used with CycleBeads®, is an effective FAM that can be taught in a short time. Community focus groups (n=50 participants) and staff interviews (n=30) conducted during the needs assessment revealed potential demand for FAM within each community and provider willingness to offer SDM. Utilizing needs assessment results, an introduction strategy was tailored to each setting. Results of post-introduction interviews with staff (n=25) and clients (n=41) indicate that after an initial learning curve, staff found SDM easy to teach and wanted to continue offering it. Clients chose SDM because it had no hormones or side effects and reported a high degree of satisfaction (100% of continuing users) and improvement in their partner relationship (40%) as a result of SDM use. However, the low number of users indicated by service statistics, and the fact that 93% of users first heard about SDM from the health center, suggest that more efforts are required to raise awareness so potential clients know to ask for the method and staff remember to offer it.